Assessment of the Value of Scintigraphic Procedures: A Case Study

  • B. J. McNeil
  • S. G. Pauker
Conference paper


Over the past 15 years, nuclear medicine techniques have grown at nearly a logarithmic rate. In view of increasing concern over rising health care expenditures, the proper evaluation of new scintigraphic tests becomes increasingly important. In this context “proper evaluation” must be clearly defined so that accurate quantification of results is possible. Any overall evaluation of new scintigraphic procedures rests first upon evaluation of improvements in diagnostic accuracy, that is, the sensitivity and specificity of the test, and then upon evaluation of the impact of these improvements on health outcomes. The first point can be approached directly through studies designed to assess the ability of a test to detect patients with disease and to separate them from patients without disease or with other diseases. The second point is more difficult because it requires selection of an appropriate measure for assessing health outcomes.


Survival Characteristic Patient Attitude Risk Averse Operable Patient Bronchogenic Carcinoma 
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  1. 1.
    McNeil BJ, Weichselbaum R, Pauker SG (1978) Fallacy of the five year survival in lung cancer. N Engl J Med 299: 1397–1401PubMedCrossRefGoogle Scholar
  2. 2.
    Mountain CF (1976) The relationship of prognosis to morphology and the anatomic extent of disease; studies of a new clinical staging system. In: Israel L, Chaninian P (eds) Lung cancer. Academic Press, New YorkGoogle Scholar
  3. 3.
    Mountain CF, Carr DT, Anderson WAD (1974) A system for clinical staging of lung cancer. Am J Roentgenol Rad Ther Nucl Med 120: 130–138Google Scholar
  4. 4.
    Matthews MJ, Kanhouwa S, Pickren J (1973) Frequency of residual and metastatic tumor in patients undergoing curative surgical resection for lung cancer. Cancer Chemother Res [Suppl] 4: 63–67Google Scholar
  5. 5.
    Weiss W (1974) Operative mortality and five year survival rates in patients with bronchogenic carcinoma. Am J Surg 128: 799–804PubMedCrossRefGoogle Scholar
  6. 6.
    Hilton G (1960) Present position relating to cancer of the lung: Results with radiotherapy alone. Thorax 15: 17–18PubMedGoogle Scholar
  7. 7.
    Jordan CW (1975) Life contingencies. Society of actuaries, Chicago, pp 173–175Google Scholar
  8. 8.
    Keeney RL, Raiffa H (1976) Decision with multiple objectives: Preferences and value tradeoffs. John Wiley, New YorkGoogle Scholar
  9. 9.
    Raiffa H (1970) Decision analysis: Introductory lectures on choices under uncertainty. Reading MA, Addison-WesleyGoogle Scholar
  10. 10.
    Arrow KJ (1973) Government decision making and the preciousness of life. In: Tancredi L (ed) Papers of the Conference on Health Care and Changing Values. Institute of Medicine, National Academy of Sciences, pp 33–47Google Scholar
  11. 11.
    McNeil BJ, Pauker SG (1979) The patient’s role in assessing the value of diagnostic tests. Radiology 132: 605–610PubMedGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1980

Authors and Affiliations

  • B. J. McNeil
    • 1
    • 2
  • S. G. Pauker
    • 1
    • 2
  1. 1.Department of RadiologyHarvard Medical SchoolBostonUSA
  2. 2.Department of MedicineNew England Medical Center Hospital and Tufts University School of MedicineBostonUSA

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